Mr. Jim Breslin:

In my opening statement I referred to implementation issues which are available to us in constructing the next arrangement, and that we would learn from that.

I wish to emphasise that from the outset continuity of care was a really important objective of all of the parties that sought to make this work. It was provided for in the heads of terms with the private hospitals in two respects. On the day we entered into the arrangement there were patients in the hospitals, and it was important they had continuity of care. There were also patients who were undergoing a treatment plan with a private consultant, and the arrangement in that case was twofold. The ideal situation was the private consultant signed up to the contract that was offered on an agreed basis, in which case he or she could continue to see all of his or her patients under the new arrangement. The only distinction was that he or she could not charge the patient a fee, but that patient would still get continuity of care, and 291 consultants signed up. In the event that a consultant did not, a patient might wish to stay with that consultant. However, if he or she wanted, for example, to be admitted to a private hospital, he or she would need to be admitted under the care of another consultant. This would be either an existing public consultant, or one of those who had signed up to the private arrangement, in which case the patient's continuity of care would be facilitated by a transfer at the point in the care that he or she was at - not going back to his or her GP and starting from scratch, but at that point in his or her care. Issues arose with that, but that was the clear objective we all sought to try to bring about.